The effect of self-efficacy and outcome expectation on medication adherence behavior.

Medication adherence still ranks as a big challenge for clinicians and health workers. Based on a social learning theoretical framework, this study explores the adoption of patient adherence, medication adherence as a catalyst for improving the health and quality of life of individuals in Nigeria. Structural Equation Modelling technique was used to analyze the empirical data obtained. SLT variables including self-efficacy and outcome expectation were tested against medication adherence behavior. The constructs are related and positively correlated except definition which is contrary to previous researches. The research discusses these findings while also highlighting the implications for practice and policy.

Investigating the resistance to telemedicine in Ethiopia.

BACKGROUND: Telemedicine has great potential to improve health care in Africa as well as other developing areas, especially when medical expertise is urgently needed in emergency situations. Yet resistance from healthcare professionals could prevent telemedicine's social value from being materialized. OBJECTIVE: This article intends to understand why healthcare providers resist using telemedicine from a threat-control perspective. METHOD: A survey on 107 healthcare professionals in Ethiopia was conducted. CONCLUSIONS: The resistance to telemedicine is determined by perceived threat and perceived controllability, which in turn are influenced by reduced autonomy, anxiety, and costs. Government support weakens the effect of perceived threat but strengthens the effect of perceived controllability on telemedicine resistance.

A framework for sustainable implementation of e-medicine in transitioning countries.

Organizations in developed countries such as the United States of America and Canada face difficulties and challenges in technology transfer from one organization to another; the complexity of problems easily compounds when such transfers are attempted from developed to developing countries due to differing socioeconomic and cultural environments. There is a gap in the formation of research and education programs to address technology transfer issues that go beyond just transferring the technologies to sustaining such transfers for longer periods. This study examined telemedicine transfer challenges in three Sub-Sahara African countries and developed a framework for sustainable implementation of e-medicine. Both quantitative and qualitative research methods were used. The study findings indicate that e-medicine sustainability in Sub-Saharan Africa is affected by institutional factors such as institutional environment and knowledge management practices; technical factors such as the technological environment and technology transfer project environment; social environmental factors such as social environment and donor involvement. These factors were used to model the proposed framework.

Telemedicine in acute-phase injury management: a review of practice and advancements.

OBJECTIVES: To offer a systematic review of the body of literature in the emerging field of telemedicine in the management of acute-phase injuries. MATERIALS AND METHODS: We conducted a literature review. RESULTS: Telemedicine has only recently been applied to the specialties of trauma, emergency care, and surgery. The potential benefits of telemedicine include a decrease in travel expenses, enhanced continuity of care, and increased access to specialized consultants in medically underserved and rural areas. CONCLUSIONS: There still exist barriers to the use of teletechnologies in medicine that limit their wider adoption. Poor infrastructure, limited equipment availability, and insufficient access to training and education for medical personnel have prevented wider use.

Transfer and adoption of advanced information technology solutions in resource-poor environments: the case of telemedicine systems adoption in Ethiopia.

The study of the adoption of information technology (IT) by individuals has taken two approaches, one emphasizing rationalistic goal-oriented behavior and the other focusing on poignant forces that influence an individual's reaction to a new IT. These approaches are not necessarily mutually exclusive. Individuals' acceptance and subsequent usage of a new IT is predicated on both. Additionally, the tendency in past studies has been to examine either the rational or the poignant factors in the context of a "resource-rich" environment-one in which there is an abundance of IT, adequate infrastructure, and a high level of acculturation to technology solutions. Consequently, there is a clear need for the examination of these factors in resource-poor environments, where assumptions on technology abundance and technology culturation do not hold. We empirically test a model that explains the intention of physicians in a resource-poor environment (epitomized by rural Ethiopia) to adopt telemedicine systems. This model integrates the rational factors driving goal-oriented behavior with the poignant/emotive factors that are an innate part of each adopter's reaction to the new technology. We use the model to expose salient contextual factors that explain the acceptance behavior of individuals toward complex information and communications technology (ICT) solutions and implications of these on the management of technology transfer initiatives in a resource-poor environment. The model is parsimonious, yet explains 28% of the variance in the intention to adopt telemedicine systems and 58% in perceived ease of use. The theoretical and practical implications of this model are discussed. Namely, Sub-Saharan African, in general, and Ethiopian culture, in particular, plays an integral role in the adoption of ICT solutions. Organizational positions and roles among physicians, clinical professionals, and superiors stand to impact the adoption of telemedicine and other healthcare applications. Last, the degree to which users perceive that ICT is easy to use (i.e., ease of use) can be a function of technology experience and can influence perceived usefulness on behalf of users and healthcare organizations.

An Overview of Potential Factors for Effective Telemedicine Transfer to Sub-Saharan Africa.

This paper gives an overview of core factors mitigating effective transfer of TeleMedicine to Sub-Saharan Africa (SSA) as a capability for improving the extremely poor state of healthcare delivery systems in that region of the world. Using specific examples of TeleMedicine applications, such as in TeleRadiology and health education, the paper highlights the importance of TeleMedicine in SSA. It then presents the salient factors that influence TeleMedicine technology transfer in the form of a conceptual framework. In explaining the framework, the paper offers opinions and supportive arguments on the importance and significance of the identified factors in effective TeleMedicine "uptake" within the SSA. We believe the framework provides a grounded theoretical basis that information and communications technologies (ICT) or technology transfer researchers can use for empirical investigation in order to understand the efficacy of TeleMedicine adoption within developing countries at large.

What is telemedicine? A collection of 104 peer-reviewed perspectives and theoretical underpinnings.

Nearly half a century ago, telemedicine was disregarded for being an unwieldy, unreliable, and unaffordable technology. Rapidly evolving telecommunications and information technologies have provided a solid foundation for telemedicine as a feasible, dependable, and useful technology. Practitioners from a variety of medical specialties have claimed success in their telemedicine pursuits. Gradually, this new modality of healthcare delivery is finding its way into the mainstream medicine. As a multidisciplinary, dynamic, and continually evolving tool in medicine, researchers and users have developed various definitions for telemedicine. The meaning of telemedicine encapsulated in these definitions varies with the context in which the term was applied. An analysis of these definitions can play an important role in improving understanding about telemedicine. In this paper we present an extensive literature review that produced 104 peer-reviewed definitions of telemedicine. These definitions have been analyzed to highlight the context in which the term has been defined. The paper also suggests a definition of modern telemedicine. The authors suggest that telemedicine is a branch of e-health that uses communications networks for delivery of healthcare services and medical education from one geographical location to another. It is deployed to overcome issues like uneven distribution and shortage of infrastructural and human resources. We expect that this study will enhance the level of understanding and meaning of telemedicine among stakeholders, new entrants, and researchers, eventually enabling a better quality of life.

Differences in public and private sector adoption of telemedicine: Indian case study for sectoral adoption.

Telemedicine is the use of communication networks to exchange medical information for providing healthcare services and medical education from one site to another. The application of telemedicine is more promising in economically developing countries with agrarian societies. The American Telemedicine Association (ATA) identifies three healthcare services: clinical medical services, health and medical education, and consumer health information. However, it is not clear how these services can be adopted by different sectors: public and private. This paper looks at four Indian case studies, two each in public and private sectors to understand two research questions: Are there differences in telemedicine adoption between public and private hospitals. If there are differences: What are the differences in telemedicine adoption between public and private sectors? Authors have used the extant literature in telemedicine and healthcare to frame theoretical background, describe the research setting, present the case studies, and provide discussion and conclusions about their findings. Authors believe that as India continues to develop its telemedicine infrastructures, especially with continued government support through subsidies to private telemedicine initiatives, its upward trend in healthcare will continue. This is expected to put India on the path to increase its life expectancy rates, especially for it rural community which constitute over 70% of its populace.

Telemedicine diffusion in a developing country: the case of India (March 2004).

Telemedicine (health-care delivery where physicians examine distant patients using telecommunications technologies) has been heralded as one of several possible solutions to some of the medical dilemmas that face many developing countries. In this study, we examine the current state of telemedicine in a developing country, India. Telemedicine has brought a plethora of benefits to the populace of India, especially those living in rural and remote areas (constituting about 70% of India's population). We discuss three Indian telemedicine implementation cases, consolidate lessons learned from the cases, and culminate with potential researchable critical success factors that account for the growth and modest successes of telemedicine in India.